That’s the question many physicians, nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs) and physician assistants (PAs) are asking in the wake of a tidal wave of prosecutions related to pain medicine. This has been partly spurred on by the “opioid epidemic.” There has been a sharp spike in convictions—either by guilty plea or by conviction after a trial—of health care professionals involved in pain medicine.

The facts of each case are different, but the gist of each charge is that health care providers are operating a “pill mill,” where prescriptions are being provided “outside the usual course of medical practice” and “not for a legitimate medical purpose.” There also may be a charge that procedures or tests are not “medically necessary.”